J Korean Soc Radiol.  2013 Mar;68(3):225-228. 10.3348/jksr.2013.68.3.225.

Interstitial Injection Mammoplasty Mimicking Diffuse Infiltrative Disease in a Male Patient

• Chae IH
• Cha ES
• Lee JE
• Cheong J
• Sung SH

• KMID: 1748456
• DOI: http://doi.org/10.3348/jksr.2013.68.3.225

Abstract

Foreign material injection for breast augmentation has been performed for decades, primarily in Asia. Various materials have been used clinically for injection; their typical imaging findings are well-known and have been reported in many cases. However, these cases usually involve an injection of a foreign material for female breast augmentation. We report here the unusual imaging findings in a 64-year-old male with lipogranulomatous inflammatory changes in his breast, caused by an interstitial injection of paraffin. Mammograms show the enlargement of both breasts as well as an increased density with combined skin and trabecular thickening. Ultrasonography revealed bilateral, severely thickened skin and diffuse edematous change along the subcutaneous fat layer. Further, a few oil cysts and ill-defined hypoechoic lesions with posterior acoustic shadowing were noted in both breasts.

MeSH Terms

Acoustics
Asia
Breast
Female
Humans
Male
Mammaplasty
Mammography
Paraffin
Shadowing (Histology)
Skin
Subcutaneous Fat
Paraffin

Figure

• 

  Fig. 1 A 64-year-old male patient with breast enlargement. Breast ultrasound showed diffuse edematous changes along the subcutaneous fat layer and surface skin thickening in both breasts. A. Diffuse intraparenchymal shadowing similar to the "snowstorm" appearance was seen in the center of both breasts. B. Round-to-oval anechoic cysts, suggestive of oil cysts, were seen in both breasts. C. Paraffin uptake by lymph nodes was seen as diffuse increased echogenic lesions with dirty acoustic shadowing in both axillae. D. Bilateral standard mammograms showed enlargement of both breasts and increased density with combined skin and trabecular thickening.

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  Fig. 2 Follow-up sonography 14 months later. A. Breast ultrasonography showed ill-defined hypoechoic lesions with diffuse intraparenchymal shadowing in both breasts without interval change. B. Ultrasound-guided core needle biopsy using a 14-gauge needle was performed in the upper portion of both breasts. C. Photomicrograph showed foreign body granuloma with severe sclerosing lipogranulomatous inflammation, compatible with paraffinoma (hematoxylin & eosin; × 200).

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